Ouagadougou, Burkina Faso
The practice of female genital mutilation in
Africa has fallen sharply over the past 18 years, the Inter-African
Committee to Fight Excision said on Friday.

The committee, set up by the Organisation of African Unity (OAU), reported
an "enormous success" in its programme, launched in 1984.

"Female circumcision was the rule in 30 African countries 18 years ago.
Today, demographic studies have shown that in many nations it has reduced
by a third," Morissanda Kouyate, director of the committee's operations,
said in Ouagadougou.

"This represents an important step forward," he said, adding: "Ten years
ago no country would have dared to introduce legislation against female
circumcision. Today it is banned in some 12 countries."

The committee, which is also fighting for the rehabilitation of mutilated
women, has offices in 30 African countries.

The College of Physicians and Surgeons of Saskatchewan has advised its members to "accurately and effectively convey the message" that infant male circumcision is "not a recommended procedure."

The memo says that routine infant circumcision is inconsistent with good
medical practice, and that parental consent for this operation may not be
truly informed (and hence legally ineffective).

The memo contrasts the relatively high rate of infant male circumcision in
Saskatchewan (27.6%) with the much lower rates prevailing in the
easternmost provinces (1.5% in Nova Scotia, 0.6% in Newfoundland and
Labrador). It concludes with a warning that doctors who continue
performing newborn circumcision, even for religious reasons, should seek
legal advice and carry adequate insurance.

REGINA (CP) - Routine circumcisions on baby boys is an
unnecessary medical procedure, the College of Physicians
and Surgeons of Saskatchewan said Wednesday.

"For almost 2½
decades now the Canadian
Pediatric Society has pointed out there really is no
research evidence to suggest benefit from the procedure that
outweighs the risks of performing the procedure," said
college registrar Dr. Dennis Kendel....

-- The Florida Board of Medicine imposed a $5,000 fine on Dr. Eva Salamon, a Winter Haven obstetrician, for doing a circumcision on a baby boy without the parents' consent.

She must give a one-hour lecture on wrong-patient surgery, do 20 hours of community service and take five additional hours of continuing education in risk management. She also will pay $889.70 in costs for investigating the situation, an investigation that took place after Winter Haven Hospital filed a serious incident report.

She and the Agency for Health Care Administration, which investigates complaints for the Department of Health, had agreed on those terms in a proposed consent agreement given the Florida Board of Medicine on Friday. The board accepted the consent agreement.

Salamon said she isn't at liberty to talk about the situation, other than to confirm the board's action.

The boy was born at 8:25 a.m. Nov. 25, 2000. The surgery took place at 10:30 a.m. the next day, according to the agency's investigative report.
...

The hospital's policy at that time was for nursing staff to confirm that a signed consent form was in the patient's chart before a physician did a circumcision, according to the investigative report.

The report said Linda Bradway, the hospital's risk manager, said the staff didn't do that Nov. 26, 2000, but that the policy and procedures were revised afterward to make sure a consent form is present.

It also quoted notes written by Salamon that state: "Circumcision was performed on this infant without a permit. I went to speak to the mother and explained the mistake. Circumcision was uncomplicated."

[The way is now open for the parents to sue the doctor, and 16 years from now, for the son to.]

A Melbourne doctor allegedly performed surgery on his 37-year-old
patient's penis without consent, telling him circumcision would bring him
success with women, a hearing was told today.

The Medical Practitioners Board of Victoria is investigating Dr
X for professional misconduct during a single
consultation at a Broadmeadows clinic in May 2000.

During the consultation, which went for longer than normal, Dr X
allegedly told the man, now 39, that the top part of his foreskin was the
source of his problems with women.

A notice of the allegations being considered by the board hearing
today reads: "You told your patient that circumcision would help get
him girls by making his penis appear bigger."

The precise extent of the "surgical procedure" carried out by the
general practitioner was not revealed before the hearing was closed.

Dr X allegedly interrupted the consultation to attend another
patient, leaving the man with his "pants down and sexually aroused"
before giving him some cream and telling him to masturbate.

He is also accused of telling his patient that his history of self
mutilation was normal and offering to send him to "places where S and M
leather things happen" or organising "a girl for the purposes of sex".

Alcohol consumption in developing countries increases the risk of HIV
infection, possibly explaining the lower prevalence of HIV infection among
Muslims, a study has found

Researchers from the Medical Research Council Programme on Aids in
Uganda questioned 2 374 sexually active adults from 15 villages in the
southwest of the country. After being kept under epidemiological
surveillance for eight years, the participants were asked about their
history of alcohol consumption and the sale of alcohol in their
households. After informed consent, they were tested for HIV/Aids. The
study showed that HIV prevalence was higher among adults who consumed
alcohol than those who never drank. Non-Muslims were 14 times more likely
to have used alcohol, and twice as likely to be HIV positive.

Professor James Whitworth, one of the researchers involved in the study,
said that the relationship between religion, HIV prevalence and alcohol
was an "intriguing finding". In other studies, the link between religion
and HIV prevalence had been related to male circumcision, and few studies
have explored the effect of alcohol. Future studies of HIV infection among
Muslims needed to investigate this further, he said.

Public health campaigns need to stress the relationship between HIV/Aids
and alcohol, the study noted.

"In Uganda, I've seen one or two posters that depict a man sitting in a
bar drinking and health-related warnings about the dangers of HIV/Aids,"
said Whitworth. He suggested that bar owners should play a role by selling
condoms at bars.

The main method for HIV transmission in sub-Saharan Africa is
heterosexual contact. Drinking alcohol can increase the risk of HIV
infection by reducing the chances of condom use, increasing sexual
activity and weakening personal control, the study suggested.

For more details: http://ije.oupjournals.org/cgi/content/abstract/29/5/911
- Plusnews

Hunger, drought, scarcity of water, a lack of hospitals and medicine and
frequent cattle rustling raids that force her to abandon her home top the
list.

Clearly, an increasingly intense debate in Kenya about female
circumcision has escaped her list of worries.

``I have to take my children to be circumcised because this is what I got
from my grandparents,'' 32-year old Komolion said while her baby girl
played in the distance. ``This is the culture we have, this is the way we
found it.''

Komolion's attitude is entrenched among most women and young
girls living in rural Kenya, where many people still highly value female
circumcision despite efforts by the government, churches and civic groups
to stamp out the practice.

President Daniel arap Moi outlawed the circumcision of girls under
the age of 17 in December, introducing prison terms and penalties of up to
50,000 shillings ($640), a huge amount of money for most Kenyans who earn
less than a dollar a day.

Opponents of circumcision say it is painful, outdated and carries
grave health risks, but criminalizing the practice will not deter
uneducated people like Komolion, nor their leaders in remote areas
like the Kacheliba constituency in western Kenya.

``I don't like the view people have taken to approaching the problem by
condemnation, by demonizing people who practice it and making it look like
they are primitive,'' said Samuel Poghisio, an assistant minister from
Kacheliba.

RITE OF PASSAGE

Like most Kenyan tribes who practice female circumcision, the cattle-
tending Pokot community living in Kacheliba view it as a rite of passage
from girlhood to womanhood.

More importantly, they believe it controls a woman's appetite for sex,
putting a lid on promiscuity.

The nomadic Pokot men insist on marrying only circumcised women
because they are more likely to find them ``untouched'' when they
return from months of wandering in search of scarce water and
grazing land for their cattle in the arid landscape.

``We prefer the girls we marry to be circumcised because it reduces
adultery,'' said 31-year-old Lomunyongole Anokile, switching his
spear from one hand to the other as he peered over the thick bushes
to survey his herd of cattle.

Girls too accept the argument, believing it would be difficult to find a
husband if they are not circumcised

Even worse is the fear of dealing with the community, which
stigmatizes uncircumcised women and labels them cowards. Such
girls would rather commit suicide than stay uncircumcised

``We as girls have no alternative but to carry on with it because there is
no other way of showing courage and passage into adulthood,'' said 16-year
old Nakiru Dawan, the most outspoken of a group of friends circumcised
this month.

The girls, beautifully dressed in yellow and black beaded collars,
know they will soon find a man to marry.

EDUCATED GIRLS DON'T

But not all girls choose the same path to adulthood.

Francesca Lushake and a group of her friends who have just
completed secondary education carry glowing candles and sing
songs at a ceremony in another Pokot area to symbolize that they
have seen the light and no longer dwell in darkness.

It is the climax of an alternative rite of passage, referred to as
``circumcision by words'' as opposed to the physical ritual.

The alternative ceremony -- still very a much a minority practice -- is
held after a seclusion period during which older women teach girls how to
be good mothers and wives.

But even after the alternative rite, girls like Lushake are still looked
down upon by many in the community.

``As a girl whose parents have been circumcised, people always ask
me 'If your mother, your parents, your grandmother have been
circumcised, who do you think you are?''' she said.

But Lushake is determined not to give in to the pressure because her
schooling has taught her that circumcision often leads to infections,
infertility and death during childbirth.

Normally the circumcision is carried out as a clitoridectomy or
infibulation -- the total removal of the clitoris and the labia minora.
Health experts estimate that up to a third of Kenyan women have undergone
some form of circumcision.

MEN NO LONGER CIRCUMCISED

But interestingly, pastoralist Pokot men living on the border with
Uganda have given up circumcising males.

About three decades ago, 30 boys who had been recovering from
the operation were killed in a cross-border attack by members of the
Ugandan Karimojong tribe.

Since then, boys have undergone a ``non-circumcision'' ritual known
as ``Sapana.''

The initiate has to spear a bull at sunrise, old men feast on meat and
milk and later bless the young man by smearing mud on his head to mark his
transition into adulthood.

``If we circumcise boys we are raided by enemies. We need the boys
for defense,'' said 65 year-old Kokorng'ole Kongole.

With AK-47 rifles at the ready, men clad in just a wrap of cloth spend
most of their time thinking about cattle, the Pokot's lifeline.

Cows are so integral to Pokot life that women even use the animals'
urine to wash their utensils, collecting it at dawn before the cattle
leave to graze. Feeding the cattle and protecting them from raids totally
preoccupies the Pokot men.

In return for providing security for the family, men expect women to be
submissive on issues like female circumcision.

Experts say attitudes will be hard to change, all the more so because the
preoccupation with cattle keeps many children out of schools and within
the confines of traditional values.

Critics say opponents of female circumcision should first attend to the
basic needs of poor people like Komolion before focusing on trying to
eradicate the practice.

Francesca believes the battle will eventually be won, although it may take
many years. ``I believe with time girls who have not gone to school will
understand,'' she said.

[This is an apparent exception to the general rule that where females are circumcised, males are also. But notice that the Pokot used to circumcise males and have given it up.]